Organization
BEENA KOPPUZHA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEENA C KOPPUZHA M.D. (PHYSICIAN)
(941) 475-6568
Entity
Organization
Contact information
Practice address
1141 S MCCALL RD, ENGLEWOOD, FL 34223-4229
(941) 475-6568
(941) 474-6706
Mailing address
1141 S MCCALL RD, ENGLEWOOD, FL 34223-4229
(941) 475-6568
(941) 474-6706
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0075143
FL
Other
Enumeration date
06/09/2006
Last updated
07/16/2010
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